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Published on: February 3, 2023
Altered adiposity after extremely preterm birth
Sabita Uthaya1, E Louise Thomas, Gavin Hamilton
1Division of Paediatrics, Obstetrics & Gynaecology, Faculty of Medicine, Imperial College London, Chelsea & Westminster Hospital, 369 Fulham Rd., London SW10 9NH, UK.
Insights
Preterm infants show altered body composition at term age, with less subcutaneous fat and more intra-abdominal fat. Accelerated growth and illness severity impact adiposity, potentially increasing later metabolic risks.
Area of Science:
- Neonatal Medicine
- Pediatric Endocrinology
- Body Composition Analysis
Background:
- Adipose tissue quantity and distribution are key indicators of morbidity risk.
- The third trimester is critical for rapid adipose tissue deposition.
- Preterm infants may experience altered adiposity due to premature birth.
Purpose of the Study:
- To investigate body composition differences in preterm infants compared to term-born infants at term-equivalent age.
- To explore the relationship between postnatal growth, illness severity, and adipose tissue distribution in preterm infants.
Main Methods:
- Whole-body magnetic resonance imaging (MRI) was used to quantify adipose tissue volumes.
- Anthropometric indices were measured in preterm (<32 wk gestational age) and term-born infants.
- Data were collected at term-equivalent age for preterm infants.
Main Results:
- Preterm infants were lighter and shorter but had similar total adiposity compared to term-born infants at term-equivalent age.
- Preterm infants exhibited significantly reduced subcutaneous adipose tissue and increased intra-abdominal adipose tissue.
- Accelerated postnatal weight gain correlated with increased total and subcutaneous adiposity; illness severity was linked to increased intra-abdominal adiposity.
Conclusions:
- Preterm infants experience altered adipose tissue partitioning, with reduced subcutaneous and increased intra-abdominal fat.
- Accelerated postnatal growth and illness severity are significant factors influencing adiposity in preterm infants.
- These adiposity changes may contribute to the increased risk of metabolic complications later in life for preterm infants.
Abstract:
The quantity and distribution of adipose tissue are markers of morbidity risk. The third trimester of human development is a period of rapid adipose tissue deposition. Preterm infants may be at risk of altered adiposity. We measured anthropometric indices and quantified total, subcutaneous, and intraabdominal adipose tissue volumes using whole-body magnetic resonance adipose tissue imaging in 38 infants born at <32 wk gestational age, when they reached term, and 29 term-born infants. The preterm infants at term were significantly lighter and shorter than the term-born infants, but there was no significant difference in head circumference SD score or total adiposity. The preterm infants had a highly significant decrease in subcutaneous adipose tissue and significantly increased intraabdominal adipose tissue. Accelerated postnatal weight gain was accompanied by increased total and subcutaneous adiposity. Illness severity was the principal determinant of increased intraabdominal adiposity. Our data provide evidence of causal pathways linking accelerated postnatal growth with increased total and subcutaneous adiposity, and illness severity with altered adipose tissue partitioning. We suggest that these observations may in part explain the associations between small size at birth and later disease. Preterm infants may be at risk in later life of metabolic complications through increased and aberrant adiposity.
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